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Nebraska rates for HCPCS A5513

For Diabetics Only Multiple Density Insert Custom Molded From Model Of Patients Foot Total Contact With Patients Foot Including Arch Base Layer Minimum Of 3/16 Inch Material Of Shore A 35 Durometer Or Higher Includes Arch Filler And Other Shaping Material Custom Fabricated Each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$44.78 / $44.78 / $44.78
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.53 / $44.78 / $58.21
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.97 / $45.97 / $54.08
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.53 / $52.28 / $52.81
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$36.21 / $59.49 / $59.49
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.21 / $59.49 / $91.72
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.94 / $54.08 / $253.09
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.59 / $29.28 / $53.00
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$59.32 / $59.49 / $74.94
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$49.46 / $70.30 / $122.54
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.12 / $26.98 / $42.33